This Field Trip Permission & Consent Form ("Form") is executed by the undersigned parent or legal guardian ("Parent") of the student identified below, in connection with a school-sponsored field trip organized by __________ (Unified School District). By signing this Form, Parent authorizes the student's participation in the trip described below and acknowledges the notices, authorizations, and releases set forth herein.

1. Student name: __________
2. Date of birth: __________
3. Grade: __________
4. School Name: __________
5. School District: Unified School District

1. Parent/guardian name: __________ (__________)
2. Phone: __________
3. Email: __________
4. Home address: __________

Emergency contact (if different from above):

1. Name: __________
2. Phone: __________
3. Relationship to student: __________

1. Destination: __________
2. Educational Purpose: Educational Field Trip
3. Date(s): __________ to __________
4. Departure time: __________
5. Return time: __________
6. Mode of transportation: __________
7. Supervising staff / Lead chaperone: __________
8. Chaperone emergency contact number: __________
9. Food & Lunch arrangements: Students should bring a bagged lunch.

Participation consent was not granted for this trip.

Assumption of risk and liability release was not acknowledged.

Emergency medical treatment authorization was not provided.

No known allergies, medical conditions, or special accommodations were reported at the time this Form was submitted.

Parent has not consented to photograph or media use. No images or recordings of the student may be used for school-related publications or media without separate written consent.

By signing below, I acknowledge that I have read and understood this Form in its entirety, that I am the parent or legal guardian of the student named above with authority to consent on the student's behalf, and that I am signing this Form willingly and voluntarily.

This field trip permission form has been officially reviewed and approved by the school administration: